Provider Demographics
NPI:1992089924
Name:COUNTY OF RUSSELL
Entity type:Organization
Organization Name:COUNTY OF RUSSELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF RUSSELL CTY COMMISSIONE
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNTZSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-483-6226
Mailing Address - Street 1:401 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:KS
Mailing Address - Zip Code:67665-2920
Mailing Address - Country:US
Mailing Address - Phone:785-483-6226
Mailing Address - Fax:785-483-2756
Practice Address - Street 1:311 S FOSSIL ST
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KS
Practice Address - Zip Code:67665-3031
Practice Address - Country:US
Practice Address - Phone:785-324-2752
Practice Address - Fax:785-445-3722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16853416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport